View of pregnant women concerning health checkups involving ultrasonography and its psychological effects

—Comparison between midwives and physicians based on the cardiac rate, salivary amylase, and STAI—

Abstract

Object
This study investigated ultrasonography examinations during prenatal checkups, the emotional impact of these examinations on pregnant women, and differences between the psychological effects of examinations performed by midwives and by doctors.
Subjects and Methods
The subjects were 215 pregnant women showing normal gestational progress to three hospitals and two maternity centers. After consenting to participate in this survey, questionnaires were completed and returned anonymously. Before and after prenatal checkups, their heartbeats, saliva amylase and the State Trait Anxiety Inventory (STAI) were measured and recorded. The pregnant women who received prenatal checkup by doctors were defined as the "doctors group" and those who received checkups by midwives were defined as "midwives group".
Results
Regarding the duration of the ultrasonography examination, midwives took 8.3±4.2 (mean±SD) minutes and the doctors took 3.7±1.6 minutes on average (P<.001). However, more than 90% of both the midwives group and doctors group were satisfied with the length of time for testing and also understood the ultrasonographic images. Regarding the frequency of using a part or whole image of the fetus, midwives frequently used the image to explain the movement of the heart (χ²=5.792, P=.016), stomach (χ²=15.669, P<.001), bladder (χ²=49.602, P<.001), brain (χ²=5.785, P=.021), umbilical cord position (χ²=8.605, P=.003). The margin of error in measuring the fetus was 9.8 ±8.1% for midwives and 10.4±6.9% for doctors on average. It was also shown that 100% of midwives group and 95.5% of doctors the group considered that having ultrasonography examination performed by midwives is highly acceptable. In both groups, the heartbeat counts and STAI scores were significantly decreased after prenatal checkups (both P<.001). As for saliva amylase, it showed a slight decrease in the midwives group after prenatal checkups, while there was an increase in the doctors group. In addition, there were no significant differences between the two groups in the variability rate of each index before and after the examination.
Conclusion
Although details of ultrasonography differed between midwives and physicians, no differences in the skills for assessing the fetal body weight, pregnant women's attitudes, and psychological effects were observed, suggesting that midwives can effectively provide medical checkups involving ultrasonography on comparison with physicians.